But since September is almost here, with the feeling of renewal, I will post again!
I have been thinking about how though making change to improve things is at times extraordinarily painful, that there are great pay offs. There have been multiple changes at work, significant ones, and I can see results that are so very positive. Such as family members saying how much they appreciate care, and thinking back to what we used to do, and now have changed things dramatically.
Like no visiting hours-with no problems. Like avoiding blanket rules and instead focusing on what specific patients need.
It is so easy to get caught up in the negative and lose sight of what we're doing, but looking at our care-I think we do a great job. And I didn't think I'd say that 5 years ago.
Thursday, August 30, 2012
Wednesday, February 29, 2012
Really
So this course I am taking ia all about relational ethics, which I would think I would be all over.
But I'm not.
I get that nurses need to be aware and willing to relate to their patients and always open to considering the effect of their care and interactions. It certainly makes sense to me.
Where I struggle is with the constant navel gazing (As Mom would put it) on how important this relationship to people getting better.
Naturally, if you are having care from a nurse, and you get good, competent, interested, engaged nursing care-that is what should happen.
But is some of this focus on the importance of nursing care, based on our own self interest?
I was looking up environment and effect of it on care and how nurses manage.
All the articles were written by nurses. well, given that it is central to what nursing does, ok I get it. But does every interaction with a nurse have to be a long relationship, or can we have small, kind interactions that do the job just as well?
I keep hearing about how as nurses we don't have enough time. But perhaps we are looking to the past too much, when people were in the hospital for a week or 2 after having a baby with no complications. Sure, there was lots of time for nurses to interact, but it wasn't needed. And though I do believe that as nurses we have an important role in people getting better-are we overestimating this role to make ourselves feel more valued? Would people get better anyway, and how much is about our needs, not the patients.
But I'm not.
I get that nurses need to be aware and willing to relate to their patients and always open to considering the effect of their care and interactions. It certainly makes sense to me.
Where I struggle is with the constant navel gazing (As Mom would put it) on how important this relationship to people getting better.
Naturally, if you are having care from a nurse, and you get good, competent, interested, engaged nursing care-that is what should happen.
But is some of this focus on the importance of nursing care, based on our own self interest?
I was looking up environment and effect of it on care and how nurses manage.
All the articles were written by nurses. well, given that it is central to what nursing does, ok I get it. But does every interaction with a nurse have to be a long relationship, or can we have small, kind interactions that do the job just as well?
I keep hearing about how as nurses we don't have enough time. But perhaps we are looking to the past too much, when people were in the hospital for a week or 2 after having a baby with no complications. Sure, there was lots of time for nurses to interact, but it wasn't needed. And though I do believe that as nurses we have an important role in people getting better-are we overestimating this role to make ourselves feel more valued? Would people get better anyway, and how much is about our needs, not the patients.
Monday, January 9, 2012
art and science
It has been a long time since I've posted, but my goal is to update this at least once per month. My other goal for the new year is to exercise and I have been doing that with success, so I will accomplish this!
I have been reflecting upon what is the art and what is the science of nursing. When I was taking my undergrad, instructors would refer to this and though I acknowledged that there was both within nursing, I don't know if I considered how this looks in mental health.
One of the reasons that some in nursing don't like mental health is because there are not a lot of physical skills, like inserting a catheter, starting an IV etc. Most of our time is spent talking, listening, and intervening in those fashions.
I think I kept trying to quantify the communication as science, and I think many in psychiatry do this want to make mental health a 'real nursing' job, with quantifiable measures and recognized by the dominant medical discourse. Hence the overreliance on medications as a 'cure'-it meets scientific/biomedical standards-medications are studied extensively and the medical community can measure side effects, efficacy etc. Not to mention our society's determination to find cures through pharmaceuticals, but that's a whole different topic.
Really, I think within mental health, the art piece is foremost, and how do we measure that?
Specifically, I was thinking of how I intervene with a patient who is angry, distressed etc. Sure, I can set out some guidelines on how to speak, what my body language should look like, but how do you scientifically quantify empathy, understanding, and gentleness?
I had a situation with a patient, who was angry and suggested to the nurse that since I had a fairly good rapport with the patient, perhaps I could try intervening. It all turned out well and the patient resettled, but when thinking about what I did, versus what could have happened, I don't know if I could quantify what I did. Obviously, I made eye contact, had open body language, listened, but how do you exactly replicate caring, and isn't that caring and empathy, the art of nursing? Now if I had jumped in and had a more intrusive intervention, such as calling a code white and giving a medication intramuscularly, perhaps it would look like I was doing more-that kind of thing lends itself to measuring much easier, held patient this long, gave this medication in this spot with this dose, this many people present. Perhaps that is part of the reason people want to jump in and deal with the situation physically and quickly-it seems like a more societally valid form of intervention? Follows the biomedical discourse?
I think within mental health, it is the artful ability to listen so that the patient knows you hear them, and the genuine connection between nurse and patient, it is not the science of 'maintain a leg's length distance while keeping direct but not intense eye contact'
Within nursing there is a difficult balance between keeping scientific rigour in our practice, while recognizing that it is the art of nursing that differentiates this branch of health from medicine. We need to balance evidence based practice with the artful interactions and human compassion. If we nurse while only using the scientific background, the empathy, caring and humanness is lost. If we only use the art of caring, it can degenerate into doing things because we've always done it this way, leading to care and interventions that may or may not work.
Interesting stuff, maybe next time I'll reflect on the biomedical reliance on medication to cure.
I have been reflecting upon what is the art and what is the science of nursing. When I was taking my undergrad, instructors would refer to this and though I acknowledged that there was both within nursing, I don't know if I considered how this looks in mental health.
One of the reasons that some in nursing don't like mental health is because there are not a lot of physical skills, like inserting a catheter, starting an IV etc. Most of our time is spent talking, listening, and intervening in those fashions.
I think I kept trying to quantify the communication as science, and I think many in psychiatry do this want to make mental health a 'real nursing' job, with quantifiable measures and recognized by the dominant medical discourse. Hence the overreliance on medications as a 'cure'-it meets scientific/biomedical standards-medications are studied extensively and the medical community can measure side effects, efficacy etc. Not to mention our society's determination to find cures through pharmaceuticals, but that's a whole different topic.
Really, I think within mental health, the art piece is foremost, and how do we measure that?
Specifically, I was thinking of how I intervene with a patient who is angry, distressed etc. Sure, I can set out some guidelines on how to speak, what my body language should look like, but how do you scientifically quantify empathy, understanding, and gentleness?
I had a situation with a patient, who was angry and suggested to the nurse that since I had a fairly good rapport with the patient, perhaps I could try intervening. It all turned out well and the patient resettled, but when thinking about what I did, versus what could have happened, I don't know if I could quantify what I did. Obviously, I made eye contact, had open body language, listened, but how do you exactly replicate caring, and isn't that caring and empathy, the art of nursing? Now if I had jumped in and had a more intrusive intervention, such as calling a code white and giving a medication intramuscularly, perhaps it would look like I was doing more-that kind of thing lends itself to measuring much easier, held patient this long, gave this medication in this spot with this dose, this many people present. Perhaps that is part of the reason people want to jump in and deal with the situation physically and quickly-it seems like a more societally valid form of intervention? Follows the biomedical discourse?
I think within mental health, it is the artful ability to listen so that the patient knows you hear them, and the genuine connection between nurse and patient, it is not the science of 'maintain a leg's length distance while keeping direct but not intense eye contact'
Within nursing there is a difficult balance between keeping scientific rigour in our practice, while recognizing that it is the art of nursing that differentiates this branch of health from medicine. We need to balance evidence based practice with the artful interactions and human compassion. If we nurse while only using the scientific background, the empathy, caring and humanness is lost. If we only use the art of caring, it can degenerate into doing things because we've always done it this way, leading to care and interventions that may or may not work.
Interesting stuff, maybe next time I'll reflect on the biomedical reliance on medication to cure.
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